Access device for anterior cervical discectomy & fusion (acdf)

Abstract

A surgical access sleeve may include a tubular braid with a closed end pocket at the distal end. The tubular braid is compressible, or it can be shortened, in a longitudinal direction, to force the tubular braid to expand radially outward. A surgical method includes inserting a substantially un-compressed access sleeve partially into an incision or opening in a patient, with the access sleeve comprising a tubular braid. The access sleeve is compressed in a longitudinal direction to force the access sleeve to expand radially outward to dilate or maintain the opening.

We claim: 
     
         1 . A surgical method, comprising:
 inserting a substantially un-compressed access sleeve partially into an opening in a patient, with the access sleeve comprising a tubular braid; and   compressing the access sleeve in a longitudinal direction to force the access sleeve to expand radially outward to dilate or maintain the opening.   
     
     
         2 . The method of  claim 1  wherein the opening is a surgical incision. 
     
     
         3 . The method of  claim 2  further including inserting a surgical instrument through the compressed access sleeve. 
     
     
         4 . The method of  claim 1  wherein the opening is a natural opening in the body of the patient. 
     
     
         5 . The method of  claim 1  wherein the tubular braid comprises polymer or nitinol. 
     
     
         6 . The method of  claim 1  wherein the access sleeve has a radial dilation strength of 2-10 Newtons. 
     
     
         7 . The method of  claim 1  wherein the tubular braid is folded over on itself to form a sleeve having a double wall structure. 
     
     
         8 . The method of  claim 7  with the double wall structure having an atraumatic and fray resistant tip due to the folding over of the braid material. 
     
     
         9 . The method of  claim 1  further comprising compressing the sleeve by tensioning at least one suture attached to a distal end of the sleeve. 
     
     
         10 . The method of  claim 9  further comprising tensioning at least two sutures attached to the distal end the sleeve. 
     
     
         11 . The method of  claim 10  further comprising steering a distal end of the sleeve via the tensioning of the at least two sutures attached to the distal end the sleeve. 
     
     
         12 . The method of  claim 2  wherein the surgical incision is in the throat of the patient for performing an anterior cervical discectomy and fusion. 
     
     
         13 . The method of  claim 1  further including inserting the access sleeve into the opening by inserting a surgical tool into a pocket at a distal end of the access sleeve, and pushing the sleeve into the incision using the surgical tool. 
     
     
         14 . A surgical method, comprising:
 inserting a substantially un-compressed access sleeve partially into an opening in a patient, with the access sleeve comprising a tubular braid; and   allowing the sleeve to contract along its longitudinal axis, with the sleeve simultaneously expanding radially outward to dilate or maintain the opening.   
     
     
         15 . The method of  claim 14  further comprising stretching the sleeve from an inherently compressed state into the substantially un-compressed state. 
     
     
         16 . A surgical sleeve, comprising:
 a tubular braid having a distal end and a proximal end;   a closed end pocket at the distal end;   the tubular braid compressible in a longitudinal direction to force the tubular braid to expand radially outward.   
     
     
         17 . The surgical sleeve of  claim 16  with the tubular braid inverted to provide a double wall thickness. 
     
     
         18 . The surgical sleeve of  claim 17  further comprising at least one tensioning suture attached to the distal end. 
     
     
         19 . The surgical sleeve of  claim 17  comprising a first suture on a first side of the tubular braid and a second suture on a second side of the tubular braid, opposite from the first side. 
     
     
         20 . The surgical sleeve of  claim 18  further including a hub attached to the proximal end, with the hub including a slot for holding the at least one tensioning suture.